Finding a suitable donor kidney for renal transplant candidates who are allosensitized to human leukocyte antigen (HLA) can be challenging. In this Review, Gloor and Stegall discuss currently available strategies for screening and desensitization and new techniques that are under development. Treatments that target donor-specific antibodies have shown some success in reversing acute antibody-mediated rejection, a common complication in antibody-incompatible kidney transplantation. New treatments, such as anti-C5 antibody-mediated complement blockade and proteasome inhibitor-mediated plasma cell depletion, are promising therapeutic avenues.
- James Gloor
- Mark D. Stegall